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Study of Cataract Outcomes and Up-Take of Services (SCOUTS) in the Caring Is Hip Project, Report 2

Nathan G. Congdon, MD, MPH; Srinivas K. Rao, MD, FRCSEd; Xiaqing Zhao, MD; Weizhao Wang, BA; Kai Choi, PhD; Dennis S. C. Lam, MBBS, MD, FRCOphth, FHKAM(Ophth)

Arch Ophthalmol. 2007;125(11):1546-1552. Published online October 22, 2007 (doi:10.1001/archophthalmol.125.11.eeb70014).

Objective  To study the postoperative visual function and uptake of refraction and second-eye surgery among persons undergoing cataract surgery in rural China.

Methods  Self-reported visual function was measured 10 to 14 months after surgery. Subjects with improvement of 2 or more lines with refraction were offered glasses, and those with significant cataract were offered second-eye surgery.

Results  Among 313 eligible subjects, 242 (77%) could be contacted; 176 (73%) of those contacted were examined. Interviewed subjects had a mean ± SD age of 69.9 ± 10.2 years, and 63.6% were female. The mean ± SD visual function score was 88.4 ± 12.3, higher than previously reported for cataract programs in rural China and significantly (P = .03) correlated with presenting vision. Forty-two percent of subjects had spectacles, more than half being reading glasses. Though 87% of subjects' vision improved with refraction, only 35% accepted prescriptions, the most common reason for refusal being lack of perceived need. Second-eye surgery was accepted by a total of 48% (85 of 176) of patients, cost being the biggest reason for refusal.

Conclusions  Visual function was high in this cohort. Potential benefit of refraction and second-eye surgery was substantial, but uptake of services was modest. Programs to improve service uptake should focus on reading glasses and cost-reduction strategies such as tiered pricing.

Author Affiliations: Department of Ophthalmology and Visual Sciences (Drs Congdon, Rao, and Lam) and Centre for Epidemiology and Biostatistics, School of Public Health (Dr Choi), The Chinese University of Hong Kong; Joint Shantou International Eye Center of Shantou University and The Chinese University of Hong Kong, Shantou (Drs Congdon, Rao, Zhao, and Lam); and Sanrao Village Hospital, Sanrao, China (Ms Wang).

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